ACT.experiential.group .for .Adolescents.L.hayes .2008

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Handouts adapted from Morton, J. (2008) Spectrum Wise Choices

Acceptance and Commitment Therapy:

Experiential Adolescent Group

Louise Hayes & Julie Rowse

2008

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Julie Rowse & Louise Hayes (2008)

CONTENTS

General Group Procedures ................................................................................................. 4

Session 1: Where am I?...................................................................................................... 9

Session 2: Thoughts: Trapped or Flexible? ...................................................................... 17

Session 3: Developing Willingness ................................................................................... 25

Session 4: Inside my mind ............................................................................................. 31

Session 5: Mindfulness - Being Present ........................................................................... 37

Session 6: This is what I value!......................................................................................... 42

Session 7: On the move................................................................................................. 47

Session 8: Reflect and remember ................................................................................. 51

WEEKLY HANDOUTS 55

References ........................................................................................................................ 66

ACT Evaluation .................................................................................................................. 67

Permission to use artwork ................................................................................................ 68

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ACKNOWLEDGEMENTS

Louise Hayes and Julie Rowse would like to acknowledge the willingness of the ACT

community to share their knowledge and resources. Many of the ideas in this program

are adaptations from other ACT works and we have attempted to acknowledge the

works of these authors. Without this commitment to sharing knowledge the

development of this program would not have occurred. We would also like to

particularly thank Laurie Greco for her willingness to share her resources and her own

work with adolescents (Greco, 2006).

Artwork used in this document should not be reproduced in anyway.

All participant artwork has been used with written consent from the participants. We

would like to express our thanks to the teenagers who have shared their experiences

with us. Thank you.

Correspondence to: Dr Louise Hayes, University of Ballarat, Mount Helen, Victoria,

Australia. [email protected]

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GENERAL GROUP PROCEDURES

The aim of this group program is to use experiential mediums, for example painting or

clay, to facilitate teenagers experience of the ACT concepts. Art allows them to explore

their own experiences, without getting caught up in language processes. The group

program also makes use of role play and other forms of experience.

Facilitators need a sound understanding of Acceptance and Commitment Therapy,

should be familiar with working with adolescents and have experience in group

facilitation. Ideally, facilitators should have worked individually with adolescent clients

before taking on this group work. It is recommended that facilitators attend ACT training

and be familiar with the literature and the Association for Contextual Behavioral Science

(www.contextualpsychology.org).

Some suggested readings include:

Greco, L. A., & Hayes, S. C. (Eds.). (2008). Acceptance and mindfulness treatments for

children and adolescents: a practitioner's guide. Oakland CA: New Harbinger.

Hayes, S. C., & Smith, S. (2005). Get out of your mind and into your life. Oakland CA: New

Harbinger.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment

Therapy: An experiential approach to behavior change. New York: The Guilford

Press.

Luoma, J. B., Hayes, S. C., & Walser, R. D. (2007). Learning ACT: an acceptance and

commitment therapy skills training manual for therapists. Oakland CA: New

Harbinger.

Zettle, R. D. (2007). ACT for depression: A clinician's guide to using acceptance and

commitment therapy in treating depression. Oakland CA: New Harbinger.

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WHO IS THIS PROGRAM FOR?

In a group format, the program is suitable for adolescents aged 13 to 18 years. We have

found that at the younger end, some teens find it hard to link the metaphors used in the

art exercises and need a bit more support. The program could be easily adapted for use

individually with clients of any age.

Selecting adolescents for the group requires some careful planning. Issues to consider

include:

1. We have included up to 8 participants with two facilitators.

2. Should the group be single sex or mixed sexes? To date we have run this only

with single sex groups as we felt that the developmental level of boys and girls

would make combined groups too challenging.

3. The range of ages within one group should be no more than two years, for

example 13 to 15 year olds, or 15 to 17 year olds.

4. Adolescents have informed us that sense of belonging is an important group

process. We aim to create a cohesive group where each participant feels

supported. Selection of participants requires some prior knowledge to the

adolescents. For our groups in schools, participants were experiencing anxious or

depressive symptoms. We excluded from the group teenagers with recent

bereavement, intellectual disability, or acute levels of mental illness (psychosis,

acute suicidality).

SESSION DURATION

The duration of ACT sessions can be 60 to 120 minutes although this can change

depending on the group location, purpose, and participants in the group. We have

found shorter duration is better than too long, but we have found after a few sessions

the adolescents are more open in the discussion and the sessions can take longer if time

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permits. To optimise attendance weekly sessions on a set day of the week at the same

time is best, for example each Wednesday at 11am for an hour.

ASSESSMENT AND INFORMED CONSENT

We strongly recommend that prior to each group the facilitators meet individually with

each participant for approximately 20-30 minutes. There are four objectives for this

meeting:

1. to assess the adolescents current mental health, giving consideration to

appropriateness for the group and referral for other services if necessary,

2. to explain why they have been asked to participate, the purpose of the group,

and the type of activities,

3. to obtain informed consent and give adolescents a brief overview of ACT,

4. to collect pre-intervention measures,

5. to assess the adolescents current mental health, giving consideration to

appropriateness for the group and referral for other services if necessary,

In schools we have found that teenagers mostly want to know why they have been

chosen. While these individual interviews are time consuming we have found without

them teenagers can be quite sceptical about participation.

Some areas for discussion include:

What the group is about?

What ACT is about we use the phrase Accept, Choose and Take action and

describe that ACT uses experiences, like art, to help teenagers learn about

valued living and dealing with difficulty.

The groups we facilitated were part of a research project and we were required to

obtain written permission from the teenagers and their parents. We used an invitation

flyer as well as the formal plain language statement required for ethical research.

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ASSESSMENT MATERIALS

Determining the effectiveness of the group is important. Outcome or process measures

will depend on your purpose for delivering this program as well as the population you

are working with. We have used general measures of adolescent well-being (Reynolds

Adolescent Depression Scale) and also included process measures specific to ACT

(Avoidance and Fusion Questionnaire, Greco).

At a minimum we recommend you administer a basic measure to obtain satisfaction and

feedback on your group process (see Handouts section).

PROCESS ISSUES

The process of facilitating the ACT art groups is important to the delivery of the

program. When painting or drawing we strongly and repeatedly explain to the

adolescents that this group is not about being a good artist or producing a great piece of

work. The artwork does not have to be a recognisable image; it can be an abstract, a

colour, a shape (if absolutely stuck they can use words). Some adolescents will require

support to begin or to understand how to express themselves with art. Facilitators can

have pre-prepared examples of how to express some of the concepts although it is best

to allow time for the adolescents to use their own creativity to ensure individual

expression.

1. Set the group up on a shared large table so everyone can see each other and talk

while they paint.

2. Facilitators must adopt the ACT I and thou stance that is central to ACT.

Facilitators also need to complete their own artwork for all activities.

3. Facilitators should model the ACT concepts with their own art, taking care to

ensure it is at an appropriate level for their participants. We usually model

simple art (often joking about our bad art) in the beginning so that no-one feels

the standard is too high. For the first painting we will often use just colours on a

page.

4. While the artwork is in progress the facilitators can encourage dialogue in

keeping with ACT processes. Sometimes the teenagers drift off into casual

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conversation and this can be OK too. Facilitators can be looking for ACT examples

and use defusing language (e.g., Our minds tell us You have the thought)

5. We do not wait for all participants to complete their work. Instead as

participants are finishing the facilitators encourage them to talk about their work

and to describe what their work is expressing. This is the greatest opportunity to

teach and model ACT in action. Facilitators share their art work too. In this way

all are given the opportunity to talk about ACT concepts within their artwork.

6. Finally, when all artwork is complete we retain this for the duration of the

program. Some weeks we use the artwork to reflect on ACT concepts. If you

have the luxury of using a room where you can display the artwork over the

weeks this is ideal. Alternatively you can bring the artwork out each week and

display during the session.

7. At the end of the group, participants can choose to take all or some of their work

home, or photograph it if they have a camera phone. Some adolescents prefer

not to take their work home for a variety of reasons (privacy, parent

interrogations, etc).

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Hayes & Rowse, 2008

SESSION 1: WHERE AM I?

ACT THERAPEUTIC AIM

In this first session we hope to develop rapport with a new group of usually nervous

teenagers. The aim is to build a shared space as a group, working together, with respect,

compassion and understanding for each other. Above all teenagers value being heard

and not judged so we usually make this explicit.

This week we gently introduce the concept of values. We aim to generate initial

thoughts about their valued direction in life. Values will be revisited later in the sessions

and explored at greater depth. At this first session the values exercise merely contrasts

that there are two places to be, stuck or living in your valued direction. We attempt to

have teens identify that there are some valued things that they can move towards, even

if these are not core values at this stage.

PROCESS ISSUES

1. Facilitate a sense of group amongst the adolescents by using open dialogue

between the facilitators and participants. This week we encourage chatting while

painting.

2. Create a sense that facilitators are comfortable adults to be with and that the

group will be fun.

KEY TASKS AND ACTIVITIES

Hayes & Rowse, 2008

1. Introduction to the group

2. Confidentiality (include limits on disclosure for a group run in a school setting)

3. Personal introductions, icebreaker to build sense of group

4. Values painting as an individual task and group discussion

5. Home task and handouts

MATERIALS

A3 white paper

Oil pastels

Charcoal

Coloured pencils

Paint red, yellow, blue, white, black

Pencil sharpener

Paper disposable palettes (at a stretch A4 copy paper will do if wax palettes are

unavailable)

Paint brushes

Water cups for painting

Paper towel

LOCATION

Preferably an art room with a sink for clean-up

ACTIVITIES

INTRODUCTION TO THE GROUP (5 MINUTES)

Hayes & Rowse, 2008

The facilitators begin by introducing themselves and explaining what the group will be

about.

Sample Dialogue:

Welcome to the group, as you are aware we will be meeting at the same time

each week for 8 (or 6) weeks. The group will hopefully be lots of fun and we will

have an opportunity to try a number of art activities while we learn. The group is

based on ACT which stands for Acceptance and Commitment Therapy, or Accept,

Choose and Take Action. ACT is a way of understanding how we can live life in

the way we value the most. We also learn how our mind works, how we learn

from experience and how our thoughts can help us and also how they can create

struggles with life. We hope to help you learn some new skills that can help steer

you through lifes ups and downs. And of course we hope you all have fun and

get to know each other at the same time.

Spend a few minutes in a group discussion about the group. Other discussions might

include:

What do you think this group could/should be about?

What do the group think values is about?

Has anyone thought about choices in life, and that we make choices everyday

What does it mean to have value in life and choose a direction we want to, even

though it might be difficult?

What does it mean to be human with all our thoughts, feelings, ups and downs

etc?

CONFIDENTIALITY, LIMITATIONS ON GROUP DISCLOSURE FOR A

GROUP RUN IN A SCHOOL SETTING (5 MINUTES)

The facilitators need to spend a few minutes setting up the group rules and ensuring

that they comply with professional and ethical requirements, whilst also taking into

account the requirements of schools or education boards.

Hayes & Rowse, 2008

The group can generate their own list of rules. Keep to a maximum of 5 or 6 rules and

ensure the following core points are covered.

Sample dialogue:

Before we start today, lets talk about how the group might run. This is a group

where we are working on getting to know ourselves and we will probably get to

know each other too. So its worth making sure we look out for each other. What

group rules do you all think we need so that we can do this?

Facilitators should prompt if needed and the rules of the group should cover the

following as a minimum:

1. Confidentiality what happens in the group stays in the group,

2. Respect and non-judgmental listening to each other, accepting that there is no

wrong way to feel, everybodys experiences are valid,

3. Sensitive issues the facilitators should consider the setting for the group and the

level of disclosure that is appropriate. In our school settings we have limited

disclosure because we do not want students to reveal sensitive information that

may become a problem for them later on in the school community (gossip, name

calling etc). However, if the group is conducted in a therapeutic setting the

disclosure of sensitive issues is often necessary and facilitators should then include

a statement on their limitations on disclosure, considering regulations on child

protection, statutory reporting etc.

Sample Dialogue:

In some of our sessions we will discuss difficult thoughts and feelings. We

encourage you to discuss only what you are OK with sharing. Some people in the

group may have worries that feel really big. These worries are often too big to

share in a group, so if you have something that you are not sure about, then the

best way is to talk with one of the facilitators after the group or to talk to a

facilitator privately while a group activity is on.

PERSONAL INTRODUCTIONS, ICEBREAKER TO BUILD SENSE OF

GROUP (5 MINUTES)

Hayes & Rowse, 2008

Spend a few minutes having the teens introduce themselves and use a quick-icebreaker.

This sample ice breaker is also a brief present moment exercise (although they wont

know of this concept yet).

Sample Dialogue:

First lets go around the room and introduce ourselves. Id like you to say your

name and then talk about your favourite food but in a slightly different way to

what you might think. First I want you all to think about eating your favourite

food. I want you to imagine the smell, the feel and the taste..... Ok now as we go

around the group I would like you to introduce yourself and describe what it

would be like if you were eating that food right now.

Il l go first. My name is Julie, right now Im imagining that I am eating Jaffas

which are my favourite lollies. When I eat them, first I can smell the orange

coating, then I feel the smooth roundness on my tongue, and then the part I love,

the crunch between my teeth and the smooth chocolate bursts out.

Start with the facilitator first and then go around the room giving each person an

opportunity. If the person does not elaborate on what it is they like about their

favourite food use prompts like do you like the smell, is it the taste or how does it feel

in your mouth?

Encourage the group to have some fun with what is similar or dissimilar about their

favourite food.

VALUES PAINTINGS INDIVIDUAL TASK WITH GROUP DISCUSSION

(40 MINUTES)

The first major task is a values exercise using art as the medium for expression. The

teens will produce two artworks (a) where they are now, and (b) where they would like

to be.

Use a metaphor to set up the task:

Introduce values using a metaphor for life. The idea is to help the teens notice where

they are now and where their values might be. Be cautious about being directional we

dont want them to paint what they want to be in life, something that teens are often

Hayes & Rowse, 2008

asked. At this early stage of the group the values this should be explored at a

comfortable level, they will be revisited in later sessions.

Sample Dialogue using Path up the mountain (Hayes, Strosahl, & Wilson, 1999):

Suppose you are bushwalking on the mountains and headed for the mountain

top. You know how mountain trails wind back and forth so sometimes you double

back and it feels like you are going in the wrong direction. Sometimes you will

even drop back to a level that will be lower than you were before. If I asked you

at a number of points to tell me how you were going, I would get a different

answer each time. If you were doubling back you would probably say things

werent going well and that you would never reach the top. If you were in an

open part where you could see the mountain top you would probably tell me

things were going really well. Imagine we were across the valley with binoculars

looking at other people on the trail, if we were asked them how we were going

they would probably say they were getting closer to the top. We would be able to

see their overall direction, and not what it looks like from down on the trail. We

would be able to see that following this crazy winding trail leads to the top.

Well today we are going to paint or draw two pictures that are a bit like this

path up the mountain. The first picture we would like you to create will show

where you are now (in our mountain metaphor this is the same as being

somewhere on the bush trail). The second picture will be what the top of your

mountain would be like, some people call this your favourite life.

On the table there are paint, pastels, charcoal, pencils, textas and crayons, you

can use whatever medium you like to create your two pictures. It doesnt have to

be an image; it can be an abstract, a colour, a shape, words, anything you like to

depict the task.

The facilitator will need to help the teens understand the task, concentrating first on the

where they are now piece of artwork. The facilitator uses the group discussion process

and time while the teens are creating to discuss values and share values that are

emerging.

Facilitators must model this first exercise by completing the task with the teens. Take

care to ensure that your own artwork facilitates the teens participation and conforms

to the ACT therapeutic stance:

It should speak to the teens from a genuine and sharing point of view

Hayes & Rowse, 2008

It should not be too complex to reinforce that the group is about expressing

yourself not about producing a masterpiece.

It should be age and culturally appropriate

Self-disclosure should only be used in the interest of the group

And it should not be so artistic that he teens feel inferior

During the activity there is ongoing discussion about the works in progress. The

facilitator might ask questions to any of the teens whilst also completing their own

artwork. This is an important aspect of the group process. The aim of the questioning is

to promote group discussions on the topic of values. Questions for participants may

include:

Where they are now questions can focus on what it feels like to be where they are

and validating that feeling. Whats it like being here?

Where they want to be questions are about their values - why is being there so

great, why is being like that so important?, what is it about that activity that

you like so much?

During the activity the path up the mountain metaphor may be helpful in discussing

with participants that life is like a journey on a trail. Aim for values that give the

participants a sense of contentment, not goals. For example I want to be independent

is a value, I want to be a nurse is a goal.

HOME TASK (5 MINUTES)

Having the teenagers complete a home task is the biggest challenge, yet the most

important in terms of learning new skills and generalisation of the tasks in the group.

This week the participants home task comes from the Path up the Mountain metaphor.

Encourage the teenagers to notice times when they are lost in the bush and also

notice times when they can see the top of the mountain.

Noticing as a home task is not always attempted by all teens; sometime a behavioural

goal gets them moving and sets up the idea that this group is about changing your

behaviour. If you feel this may be the case, the home task may be to take one small part

Hayes & Rowse, 2008

of their values ask them to choose a committed action to do between now and the next

group. For example if the teen values friendship they may commit to phoning a friend

they have not seen in a while, if they value independence their action may be to do their

own laundry this week.

This task should be described in a small and achievable way to ensure success.

Encourage the group to come back next week and share their efforts.

HANDOUTS

Provide each student with handout for this week. Some students may prefer to take a

photo of this with their cell phone cameras.

Hayes & Rowse, 2008

SESSION 2: THOUGHTS: TRAPPED OR FLEXIBLE?

ACT THERAPEUTIC AIM

This week we introduce the concepts of control and acceptance. Teens are asked to

express in their art a difficult thought or emotion. The sharing process aims to normalise

difficult thoughts. A creative hopelessness task is used to get a shared sense of having

tried many solutions to resolve difficulties or emotional pain. Finally we introduce the

concept of learning from experience, getting unstuck from thought difficulties and

comparing our experiences of a problem with our thoughts of a problem.

PROCESS ISSUES

For each of this weeks activities facilitators should orient the teens to notice that every

person in the group struggles with some difficulty, and that this is universal to all

humans.

During the art activities the facilitators should reinforce participants efforts,

commenting casually on the artworks as they take shape and keeping a general level of

chatter amongst the group. Some general chatter helps to keep the adolescents

engaged. Facilitators should be looking for ACT concepts in the general chatter that can

be turned to reinforce ACT and bring the dialogue back to the session topic.

Try to make general comments that keep the process moving while staying within the

ACT concept. For example, Jane the colour you are using looks really strong, Ill be

interested to hear what struggle it represents when you have finished.

Hayes & Rowse, 2008


1. Review home tasks

2. Introduce the Life Manual (adapted from Polk, 2008)

3. Noticing the struggle with difficult thoughts individual art task

4. Creative hopelessness group discussion

5. Learning by experience to get unstuck group task

6. Home task

MATERIALS

Chinese finger traps x I per person (these can be purchased from novelty shops or

eBay)

A3 white paper

Oil pastels

Charcoal

Coloured pencils


Pencil sharpener


unavailable)

Paint brushes


Paper towel

LOCATION


Hayes & Rowse, 2008

ACTIVITIES

REVIEW OF LAST WEEK (10 MINUTES)

Review the home task from Session 1. Ask each individual to share something about

times when they noticed that they were having some difficulty and times when they

were acting on their value. Facilitators should also provide some of their own examples:

Sample dialogue:

Welcome to week 2.

Can anyone remember how we used the Path up the Mountain metaphor?

During the week did you notice any times when you were lost in the bush or when

you could see the top of the mountain?

Before we move on with todays activity how did people feel after you went

home last week?

Did you think about what you had painted?

Did you do the task you picked from our values discussion?

INTRODUCE THE LIFE MANUAL (10 MINUTES)

This concept is adapted from Kevin Polks work using a simple life manual (see ACBS

website, www.contextualpsychology.org). The idea is to help the adolescents place the

concepts that are taught each week into an overall framework.

1. Using an A4 sheet of paper ask the adolescents to write a heading at the top

VALUES and then quickly ask them to write down things that are important to

them underneath this heading. Encourage them not to think too hard about this,

but to just note what is meaningful to them. Explain that no-one will see this

sheet and that they do not need to read it out.

Hayes & Rowse, 2008

2. Have them turn over the page and on the other side write the heading

PROBLEMS and then ask them to list all the problems they are having a this

point in their life. Teens usually need some encouragement and the facilitators

should provide appropriate prompters or model some of their own difficulties (at

a level appropriate to the group). Again, explain that at this point in time this

information is private

3. Discuss with the teenagers that in this group program we are either spending

time learning about VALUES or PROBLEMS, and that we will flip from one side to

the other. This page becomes their roadmap for the rest of the sessions.

4. Explain that todays session will focus on the PROBLEMS side of the page.

NOTICING THE STRUGGLE ART ACTIVITY (30 MINUTES)

The rationale for this exercise is using an experiential medium rather than words to elicit

the difficult thoughts each teenage struggles with. The aim is to help the teens express

their thoughts and feelings without words (although they can use words if they must).

Ask the teens to create an experience of their struggle using paint; it can be abstract or

even just one colour. We have found it helps to suggest to some teens to just begin

painting, without any direction, and see where the activity takes them.

Sample dialogue:

OK, last week we contrasted here and now with some imaginary favourite place.

Its great to imagine a favourite life, but for some of you, the where am I now

or where I would like to be pictures may have also raised some difficult feelings

about how life is going for you right now. A lot of our pictures showed a place

that looked better than where we are now.

In this group we will talk about the difficult thoughts or feelings that people

have in their l ife, and learn some new ways to experience them. For example,

when I drew my painting last week my thoughts were that sometimes Im too

busy and I thought that I want to be peaceful. I feel this way all the time. Would

anyone else like to share a difficult thought or feeling that they always have?

Discuss as a group

Hayes & Rowse, 2008

OK , now I would like you to create a painting of a difficult thought or feeling,

but I want you to choose one that you have all the time. We refer to this difficult

thought as a struggle because it is a difficulty that you have had frequently and

everybody has them. Remember your artwork can be abstract or a metaphor. So

we are asking you to create an experience in your art of what this difficulty

might look like.

After participants have created their representation give each an opportunity to share

what they have created. Again, remembering to normalise experiences of struggle,

sadness, worry, anger etc.

Aim to have each teen share something of their artwork, even if just a few words

Explain to the teenagers that lots of people struggle with difficult thoughts or

feelings

Highlight the common elements in the group artwork

If your group paint darkness and blackness, normalise this as a shared experience.

Have others felt like this?

CREATIVE HOPELESSNESS GROUP BRAINSTORM (12 MINUTES)

Facilitate a group discussion that enables the teens to get a shared sense of having tried

unsuccessful solutions to resolve their difficulties or emotional pain. The activity is a

group brainstorm using butchers paper. Ask the group to share their experiences of

what they have tried to avoid having a struggle with their thoughts and feelings.

In particular discuss that trying to avoid or control difficult thoughts and feelings often

fails. It is also important to discuss that thinking their way out of difficult thoughts is

problematic, and then contrast this with learning through experience.

Some questions to prompt discussion include:

What kind of difficult thoughts are similar for all of us?

What have we tried to get rid of the thoughts?

Hayes & Rowse, 2008

How have these strategies worked?

Did they get rid of difficulty or pain (short term or long-term)?

Did they get in the way of living where we would like to be

What do these strategies cost us in terms of living with vitality?

USING EXPERIENCE TO GET UNSTUCK GROUP ACTIVITY (8

MINUTES)

Use the Chinese finger trap metaphor (Hayes & Smith, 2005) to demonstrate that the

world of the mind and the world of experience are different. What the mind tells us will

be a solution is not always the same as our experience.

Ask the group to contrast how they think they should escape the trap and how their

experience is different. Use this as a metaphor for reflecting back that struggle does not

always work and we need to learn an alternative. That experience can tell us something

different, willingness, which will be explored in detail next week.

Sample dialogue:

We are going to use an activity to help us learn about the difference between our

experience outside our skin, and our thoughts, within our skin.

(Give each member a Chinese finger trap, with instructions to listen carefully).

I would like you to push both index fingers in, one into each end.

Ok now try to pull them out.

You will notice that as you pull them back out the straw catches and tightens.

The harder you pull, the smaller the tube gets and the tighter it holds your

fingers. Youd have to pull your fingers out of their sockets to get them out by

pulling them once theyve been caught.

Hayes & Rowse, 2008

Maybe our difficult thoughts are something like that. Maybe these tubes are like

life itself. There is no healthy way to get out of life and any attempt to do so just

restricts the room you have to move. With this little tube the only way to get

some room is to push your fingers in which makes the tube bigger. That may be

hard to do at first because everything your mind tells you is in and out not

tight and loose. Maybe you just need to come at this situation from a different

angle than what your mind tells you to do.(Hayes & Smith, 2005, p. 37)

Maybe its normal to have difficult thoughts and our experiences are a better

guide into learning how to cope with difficulties, we will explore this more next

week.

HOME TASK

The task for this week is to ask the teens to conduct an experiment with their struggle

thoughts. Ask them to notice when they have difficult thoughts and feelings, and to

notice what happens (a) if they struggle with it and try to beat it or erase it, and (b) if

they do nothing with the thought. Be clear that this is not a task to have them get rid of

things that are difficult for them the task is just to notice what happens.

Facilitators should ask each adolescent to be specific and name a difficult thought they

are having and reinforce that the we will discuss this again next week.

Sample Dialogue:

This week we would like you to conduct your own experiment. During this week

when you notice you have difficult feelings, we would like you to try one of two

things. Either (a) notice when you are trying to win over the thought and what

happens when you do this, just notice it you dont need to change or do anything

different; or (b) try to notice when the thought comes and you let it be there in

other words when you dont struggle with it. Remember this is just an

experiment and we want you to try it and see what you can report back to the

group next week.

Now Im going to ask each of you to name a difficult struggle you have with your

thoughts....

Hayes & Rowse, 2008

HANDOUTS



Hayes & Rowse, 2008

SESSION 3: DEVELOPING WILLINGNESS

ACT THERAPEUTIC AIM

This week we introduce the futility of thought control and use willingness as an

alternative. We will use several experiential activities that aim to demonstrate through

experience, rather than adding more verbal instruction, that getting unstuck from

difficult thoughts requires letting go of the struggle. The activities show that our

experience sometimes gives us different solutions than the solutions generated by

thinking.

By the end of session three group participants should have explored being willing to

make space for some difficult thoughts and should have nominated one difficulty to

work on out of the session.

PROCESS ISSUES

During this weeks activities facilitators attempt to develop some willingness in the

adolescents; helping them to be willing to experience something different and to focus

on the experience rather than their well verbal rules.

Hayes & Rowse, 2008

During the two exercises the emphasis should be on experiencing the activities, rather

than being given the answer by the facilitators.

For the monster metaphor we encourage the teenagers to come up with solutions.

Inevitably one member of the group will suggest dropping the rope. We have noticed

that teenagers can use dropping the rope as a control manoeuvre. Facilitators need to

be on the lookout for this and redirect them to being willing to take the experience with

them. Frequently the teenagers will instruct each other on what they can do and

providing this is ACT consistent this is OK too.

Homework becomes an important part of this week. By now the participants are

engaged in the group and can be more firmly encouraged to complete the home tasks.


1. Review of home task

2. Control is the problem an experience of intentional forgetting - group activity

3. Developing willingness by letting go of the rope art activity

4. Home task for this week

MATERIALS

A3 white paper

Oil pastels

Charcoal

Coloured pencils


Pencil sharpener


unavailable)

Paint brushes

Hayes & Rowse, 2008


Paper towel

LOCATION


ACTIVITIES


Review of last week - Go around the room and give people the opportunity to share

what they noticed during the week. Be specific, remind each participant and ask them

what they noticed in their experiment.

Sample Dialogue:

Welcome to week three. Todays activity is building on what we started talking

about last week so lets quickly review what we made and talked about last week

and if you thought more about it during the week what things came to your

mind.

What did people notice about difficult thoughts and feelings?

What did you notice happens if they try to think their way out of difficult

thoughts?

How did it feel to think about difficult things?

Did you do anything to avoid the feelings or thoughts?

CONTROL IS THE PROBLEM EXPERIENCE OF INTENTIONAL

FORGETTING (10 MINUTES)

An experiential exercise is used to demonstrate that all thoughts are products of our

mind and that we are unable to erase them with control moves.

Hayes & Rowse, 2008

Using the dialogue below, take the group through an exercise where they imagine their

route from home to school. Then see if they can erase that route. Create some group

dialogue on the process of forgetting, for example:

Question the group about if and how they were able to do this,

Some group members will say they were able to do this. Thats OK, have some fun

and ask them how they know they erased it,

Have some fun talking with the group about the ways they tried but failed to erase

memories,

Reinforce the point that the world of experience (outside out skin) and the world

of thoughts (inside our skin) are different and have different rules

In the work outside our skin it can be easy to get rid of things we dont like.

Sample Dialogue:

Now we are going to learn a bit more about the way our minds generate

thoughts and what happens to them once they are there.

Id like everyone to close their eyes or look at a spot on the floor. Now allow your

mind to wander through your home. Picture where you live, what your house

looks like. Picture yourself leaving your front door and going off to school. Can

you see yourself walking, riding a bike, catching the bus or getting in the car?

Now picture yourself travelling on the streets to your school. Which streets did

you go down? What things do you notice on the way? Picture your

neighbourhood as you go past. You arrive at school and walk into the building.

You come into this art room and sit down with the group.

Now I would like you to erase the journey from home to school from your mind.

Make it disappear. Try really hard.

Was anyone able to do that?

Does anyone think that the best way to get rid of difficult thoughts is to try and

forget them?

Hayes & Rowse, 2008

DEVELOPING WILLINGESS BY LETTING GO OF THE ROPE ART

ACTIVITY (30 MINUTES)

Use the Tug of War with the Monster metaphor (Zettle, 2007) to demonstrate the

futility of struggle and to allow the teens to generate alternatives to struggling. The

facilitator should allow the group to brainstorm some options. At this point it is

important that the facilitators guide the group to the realisation that dropping the rope

is the first step. However, dropping the rope should not be an instruction from the

facilitator, but a realisation from the teenagers discussion.

In each group we have facilitated we have found that the teenagers have no trouble at

all coming up with the solution to put down the rope.

Sample Dialogue:

It sounds as if your struggle is like being in a long-drawn-out tug of war with a

misery monster. Youve been pulling really hard on your end of the rope, and this

misery monster is pulling on the other end. In between you and the monster is a

bottomless pit, so if you pull really, really hard maybe you can drag this misery

monster over the edge, and with one final big tug pull it into the pit and be done

with it forever. Meanwhile, as this is going on, you can hear other kids messing

about having fun in the background. Youd really like to be having fun with them,

but you also have this tug-of-war youre in and you want to win that too. Maybe

you even tell some of the kids to just wait until you get rid of this misery

monster. But now imagine that as you pull on that rope that you, rather than the

monster, are being pulled very slowly to the bottomless pit, and so you pull even

harder. But that stil l doesnt work and you find yourself still being pulled in

closer. What are your options? (Zettle, 2007, p. 105)

Allow the group to discuss many solutions, a participant will eventually think of

dropping the rope and facilitators can then discuss this

Now, for our art activity we would like you to draw the monster, as a

representation of some difficult thoughts you might have. And then draw

yourself in the picture too. We would like to see and hear what your experience

of the struggle to beat your thoughts is like. Remember your monster might not

even look like any monster anyone has ever seen. It might even be just a colour

or an abstract shape, its up to you.

Hayes & Rowse, 2008

As each group member finishes their painting ask them to share their picture. Encourage

them to talk about their relationship between themselves and their monster. Are they

fighting with the monster? Are they trying to avoid the monster? Are they willing to let

go of the rope?

Occasionally teenagers will draw themselves as having beaten the monster. Guide the

teenagers into a discussion about what it would take to beat the monster, and if they

think it would require forgetting? Ask the group to recall what was discussed earlier in

the day about our capacity to forget or control our thoughts. Discuss that even if we can

put the rope down it can be easy to pick the rope back up and not notice until we are

struggling again.

Aim for the group to come to the conclusion that making space for the difficult thoughts

is the same as letting go of the rope.

HOME TASK

This weeks activity is to practice being willing to let go of the rope. We would like you

to select on thing in your life that the difficult thoughts get in the way of; one where you

notice that you are pulling hard on the rope and trying to drag your difficult thoughts

into a place where you can forget them.Ask the teens to think of an activity that they

have been putting off because they have been fighting with the monster. This week

their goal can be to see if they can put down the rope and do the activity.

An example from one teenage participants was that she had been avoiding seeing an

unwell family member due to anxiety about what they might look. As a willingness

exercise she decided to see her relative while being willing to have her thoughts and

feelings.

Go around the room and ask each participant to state a difficulty they have and how

they will work on willingness this week. Facilitators can write down the teenagers plans

to prompt home task completion and so that they can check back next week.

HANDOUTS



Hayes & Rowse, 2008

SESSION 4: INSIDE MY MIND

ACT THERAPEUTIC AIM

This session aims to provide participants with an understanding of how their mind

generates thoughts, the evaluative nature of language, how language becomes fused

with emotion, and how this self-narrative then restricts valued living. By the end of the

session it is anticipated that participants will have engaged in some experiential

exercises to defuse thoughts and can practice these activities outside the sessions.

PROCESS ISSUES

The process this week is to use some unusual art activities to help teenagers experience

their thought production.

In the first activity the facilitators should encourage the teenagers to get a sense of their

mind as a continual thought machine, and to create an experience of this in their own

metaphor. The dialogue for the group can be around how each participant tells a story

of their thought production.

The second activity is a diffusion activity. We have found that setting this up as an

experiment works exceptionally well. During the exercise, facilitators ask the teenagers

to consider what the experiment is about, and after their drawings are complete, to

comment on the difference between the words in the before and after stages that is

do they experience them as lighter in the second stage (not all participants will and we

simply acknowledge this when it occurs).

Hayes & Rowse, 2008


1. Review home tasks Letting go of the rope

2. Your mind as a metaphor art activity

3. Diffusing difficult thoughts art activity

4. Home task

MATERIALS

NO PAINT THIS WEEK. Use only oil pastels, charcoal, or coloured pencils. This is to

prevent the students painting over difficult thoughts.

A3 white paper

Oil pastels

Charcoal

Coloured pencils

Pencil sharpener

Paper towel

LOCATION

A classroom is fine this week, although keeping the same room for the duration of the

group if preferred.

ACTIVITIES


Once again begin the week by reviewing last weeks session and asking each participant

how they went with their home task. Begin by reminding them that we used the Tug of

War with the Monster metaphor to demonstrate how struggling with difficult thoughts

Hayes & Rowse, 2008

does not usually work as a solution to getting unstuck. Prompt the participants with

some of the following questions:

What did people notice about pulling on the rope?

Did anyone notice that they were trying to drag their difficult thoughts into a place

where they would not be bothered by them?

Did anyone notice that they were able to put the rope down sometimes?What

happened when you put it down?

Discuss each participants attempts at their willingness task.

Encourage participants to learn that getting stuck and unstuck is something that

they will need to do again and again. That they will notice the struggle and choose

to stop fighting it.

YOUR MIND AS A METAPHOR ART ACTIVITY (20 MINUTES)

This activity requires participants to use art to create their own metaphor for how their

mind works. The aim is to create an experience of their own thinking process. Some

ideas for discussion leading up to this task include:

Begin with a discussion on the job our mind does, explain that it constantly

generates thoughts, solves problems, plans for the future, tries to use thoughts to

keep us safe etc.

Discuss with the group how our thinking process means that our minds are

constantly busy,

Discuss how negative self-talk is a way of protecting ourselves from danger, but

that it is not always helpful,

You may also like to discuss the mind using metaphors. For example Kelly Wilsons

metaphor of how the mind hates being unemployed works well with teenagers, as

does the metaphor that the mind is like a computer that is never switched off,

Steve Hayes and Spencer Smith describe the process of thinking about our

thoughts as like fish swimming in water. Fish dont know they are under water,

Hayes & Rowse, 2008

they just swim in it. Thinking is like this for humans, our thoughts are so much a

part of us that we rarely are aware of thinking as a process.(Hayes & Smith, 2005,

p. 55)

Sample Dialogue:

Now I am going to ask you to create your own metaphor for your mind, using a

painting or drawing. This can seem hard but once you start it can be quite fun.

For example, some people have drawn cogs and wheels to represent their mind,

others have drawn a host of l ittle people with different jobs to do, some have

drawn cyclones, and some have drawn a peaceful parade of thoughts as colours.

It doesnt matter what you decide the important thing is that it represents the

way you think your mind thinks.

If you are stuck we find it can be easier to just begin drawing and see where it

takes you.

As participants are completing their artwork ask them to talk about their artwork. To

explain what their metaphor depicts. Facilitators will need to direct the dialogue into

and ACT understanding of the mind.

DIFFUSING DIFFICULT THOUGHTS ART ACTIVITY (20 MINUTES)

This next exercise is an experience of diffusion that follows from our previous mind

metaphor exercise. This exercise requires careful setting up to build trust with the

teenagers but works tremendously well. We tell participants that we are doing a little

experiment that will help us learn more about the way our mind learns to think about

things. We also ask them to go along with it and see what they learn. It is important that

the facilitators model their own difficult thoughts before asking the participants to write

their own.

Sample Dialogue:

By now we have learnt that we are all similar in the way we think. Now I want to

try a little experiment to see if we can learn a bit about our experience of

thinking. This may seem a little whacky but we would like you to go along with it

and see what you learn, strange experiences can sometimes teach us a great

deal!

Hayes & Rowse, 2008

OK. We know we all have difficult thoughts and that we struggle with them. We

have also seen that these thoughts come to us again and again.

Now I would like you to think of a thought that you dont like, one that comes to

your mind again and again. Pick a thought you are happy to share with the

group. For example, I often have the thought Im not good enough and it comes

to me regularly. Some other thoughts that are common include Im a failure or

I cant do this.

Now we are going to do a little experiment that will demonstrate how our minds

works with these tough thoughts, it may seem a little silly but try to go with it

and see what happens. I want you to write the difficult thought in big letters on

the page in front of you.

OK. Now we are going to decorate this paper as if it was a party banner. I want

you to decorate it any way you want but it must look like an inviting picture, it is

a party banner after all. Put party hats on the letters, tie balloons off the letters

and decorate the page with streamers.

Once the participants have completed their decorations lead a group discussion on what

happened to their thoughts in this exercise. Some prompts include:

What happens to the thoughts now?

What was it like when I asked you to write out a difficult thought? What is it like

after you decorated it? Do you feel as stuck with the thought?

Explain that we are not trying to make the thoughts disappear, but instead

learning that we can experience them differently. If we are willing to have them.

Normalise the difficult thoughts and draw attention to the similarities between

participants. We have found participants will often become quite relaxed by now

and laugh about how they have the same thoughts that other participants wrote

down.

Be prepared for a participant to say they didnt experience any change in the

thoughts. When this occurs we simply acknowledge that this is OK and discuss this

experience, or if it is appropriate you could discuss being stuck and struggling with

the thought.

Hayes & Rowse, 2008

HOME TASK

This weeks home task is to have the participants choose a diffusion activity to practice

when they have a difficult thought. Give the teenagers some ideas of what they might

do with a difficult thought; for example, they might choose to write it down in bubble

writing, or sing it to Happy Birthday, or imagine it as a bubble that floats away. The aim

is to have the teenagers try to do something different with it.

Preferably have each person generate their own strategy and state this to the group.

HANDOUTS



Hayes & Rowse, 2008

SESSION 5: MINDFULNESS - BEING PRESENT

ACT THERAPEUTIC AIM

This week we begin by reviewing the art work and concepts from the past four weeks

and have fun with a role play using the Passengers on the Bus metaphor to demonstrate

how to take our difficulties with us and live life toward our values. We then contrast this

with a present moment and self as context experience. We discuss with the group the

experience of being in the present rather than living with past or future worry, or buying

into difficult thoughts. For many teens this is their first experience of mindfulness but

we have noticed that they are able to experience the contrast between listening to the

passengers and living life in the present.

PROCESS ISSUES

This week we begin with the passengers on the bus as a role play. We use this to reflect

on what we have covered each week. The facilitators should encourage some fun with

the role play and guide the group toward acting out the metaphor.

We then move on to a present moment mindfulness exercise. We use free painting and

finger painting to experience being present.

At the conclusion of the two activities the facilitators should lead a group discussion that

contrasts listening to the passengers and just being present.


1. Review of home task

2. Moving toward values using the passengers on the bus metaphor - Role play

3. Living in the present art activity

4. Home task

MATERIALS

Hayes & Rowse, 2008

A3 white paper

Oil pastels

Charcoal

Coloured pencils


Pencil sharpener


unavailable)

Paint brushes


Paper towel

LOCATION


ACTIVITIES


Review home task from last week. Ask each participant to share their experience of

trying or using a defusion technique. Try to ensure all participants have an opportunity

to share about their experience of using diffusion and what they noticed.

LIVING TOWARD YOUR VALUES ROLE PLAY (20 MINUTES)

The Passengers on the Bus (Hayes et al., 1999) metaphor is used in a role play (as per

Polks adaptation) to introduce the concept of in a direction we want and taking our

difficult thoughts with us. Try to have lots of fun with this and you will find the students

get it.

Hayes & Rowse, 2008

1. Begin with a review of the concepts covered in each week; using one painting

from each week helps with this.

2. Explain that we are going to do a role play that shows how we might handle all

these concepts and learn to live our life with meaning.

3. Set up chairs to role play a bus, with a driver out front and 3 or 4 passengers at the

back.

4. Have one of the co-facilitators be the bus driver

5. Ask for three students to nominate as passengers

6. Ask the bus driver to whisper one difficult thought to each passenger (or you can

use the bus drivers paintings from each week to allocate roles, eg one person is

the difficult thought, one is the mind, one is the struggle)

7. The facilitator then explains that the passengers job is to distract the bus driver by

calling out the thoughts

8. Have the students take their places in the bus

9. The facilitator stands at the front of the bus, some distance away from the bus

driver. Explain to the students that the facilitator represents the destination that

the bus driver wants to take his/her bus

10. The bus drivers job is to try to drive the bus without turning around to look at the

passengers, stopping the bus, etc. The bus driver (co-facilitator) should role play

this in a way that demonstrates giving all her/his attention to the passengers: (a)

prevents him from driving, (b) sometimes makes him turn around, (c) sometimes

makes him get out of the drivers seat, and even (d) sometimes makes him stop to

try to throw a passenger off.

11. The facilitators role is then to work with the students to elicit what the metaphor

means and how the past weeks activities (of control, struggle, defusion) can

prevent us from heading in the direction we want to go in life.

LIVING IN THE PRESENT ART ACTIVITY (30 MINUTES)

Hayes & Rowse, 2008

This activity contrasts listening to the passengers with living life fully and in the present.

It is a free art activity. The object is to encourage the students to be aware of all the

sensations that relate to the painting activity, and to notice themselves noticing this.

The students free paint and are encouraged to finger paint too.

In one group the teenagers painted their hands and shook hands to share the paint,

while also noticing how the paint felt, noticing their experience of getting messy, and

noticing that they were noticing. This is a fun but messy activity!

Sample Dialogue:

Today is one of my favourite activities. Today we are going to spend time being

in the present and experiencing life, without listening to the passengers or

getting drawn into our thoughts. Your task is to paint and really experience the

sensation of being here in this room, painting. So you might paint with a brush

and notice the way it flows onto the paper, or you might finger-paint and notice

the feel, or texture of the paint. You will also notice some other things like the

room, the sounds outside etc. Your job is to just notice being here. You will also

have the weird experience of noticing that you are noticing.

When your thoughts drag you away, thats OK, notice that and come back to the

sensation of painting.

After the session allow each person an opportunity to share about how they

experienced the exercise. What did they notice? What was it like noticing the noticing?

Encourage the students to compare what this activity was like with our other activities

where we were listening to the passengers on the bus.

HOME TASK

The home task for this week is to take a time each day to have one present moment

experience. Begin with calm breathing, then ask the participants to consider one thing

they might do each day that they can do mindfully. Prompt them if needed by

suggesting they notice the sounds, smells, feel etc.

Hayes & Rowse, 2008

HANDOUTS



Hayes & Rowse, 2008

SESSION 6: THIS IS WHAT I VALUE!

ACT THERAPEUTIC AIM

This week we revisit values that were touched on in week one. We ask the teenagers to

spend some time in a group discussion on their values. Then we introduce the concept

of living life in a valued direction. By the end of this session participants should have

identified at least one positive personal attribute/value they would like to work

towards.

PROCESS ISSUES

Facilitators begin with an open discussion of what a value is and what type of valued life

teenagers might want. Explaining a value can be sticky with teenagers we also use

language like what would be your favourite life, taking all the struggle away what is

really the important stuff in you, what makes your soul sing(Witt, 2008) or what gives

you a WOW life (Morton, 2008). This exercise should not be about their goals or career

choice and it can easily get side-railed into a discussion about what they want to do

with their life. We want to avoid teenagers being overwhelmed by this kind of

discussion. For some teenagers just being present is what they value; listening to music,

being with friends, being me. After all, children spend the majority of time in the

present and it is only as teenagers that our culture seems to drag them into future

dominant thinking.

Teenagers with difficult family relationships can struggle with the concept of seeing

values in adults or qualities they like in them. Unfortunately some teenagers cannot

think of a single adult with qualities they like. We therefore ask them to reflect on what

Hayes & Rowse, 2008

they dont like and test whether the opposite is a value they hold (for example, dont

like adult who wont listen to teenagers perhaps they value being heard etc).

The process of working with clay to create a representation of valued living requires

some direction and support from the facilitators. We generally provide a range of

examples of clay models other students have made and use these to generate ideas

amongst the students. You could also try working with play doh, which can be changed

and feels less permanent.

On a practical level, we have found using a combination of coloured and white clay

works best (we use DASS lightweight air dried clay), but just one colour works fine too.


1. Review home task

2. Values discussion considering adults Group discussion

3. Create a value in clay Art activity

4. Home task

MATERIALS

Clay. We use white light weight air dry clay; a ball about the size of a baseball per

person is plenty (a 1 kilogram pack will work with three or four students). We have

found the activity works best if a number of small packets of coloured clay are also

provided.

Plastic knives

Paper towel for clean ups

LOCATION

Art room with wash up area is essential for this weeks clay exercise

ACTIVITIES


Hayes & Rowse, 2008

Review the home task from last week. Ask the participants to recount their experience

of being in the present and of noticing that they were noticing. Give each person an

opportunity to share. Encourage participants to reflect on the experience of being

present what it is like to be present here and now rather than in the future or past.

Some prompts for the discussion include:

What things did you notice?

Were there things that you noticed for the first time?

How did it feel to notice?

Did you find it difficult, did anyone notice that it is difficult to keep our mind in the

present?

INTRODUCING VALUES GROUP DISCUSSION (10 MINUTES)

Facilitate a discussion with the group about values. This discussion is easier if students

are asked first to consider values in adults that they like and then as a second task

what they dont like about some adults. We have found some teenagers have great

difficulty generating valued thoughts, particularly those who have many difficult

experiences, and asking them to consider what they dont like about adults is an easier

way to begin. They might get a bit stuck on the negative so it may take some work from

the facilitators to get them thinking about what qualities they like in adults.

The discussion should achieve each participant identifying around three values that are

important to them. Aim for values that they are passionate about. Sometimes strong

negative emotions can lead to identifying a strong positive value; for example, valuing

justice when they have had experiences of being treated unfairly. You could ask

participants to write down the values on a piece of paper. Some prompters include:

what would be your favourite life,

taking all the struggle away what is really the important stuff inside you,

what makes your soul sing(Witt, 2008)

or what gives you a WOW life (Morton, 2008).

Sample Dialogue:

Hayes & Rowse, 2008

Today we are going to have some fun with clay and use the clay to help us think

about what is important in our lives and how we can move toward what we truly

value.

Before we do this lets talk about some adults you know. I want you to think

about an adult or adults you know who are positive, adults you like or respect.

Try to identify what it is about that person you like or respect. Is it they are fun

or honest or organized or friendly or compassionate or funny?

Ok, now I want you to think about an adult or adults you try to avoid, you dont

like. Try to identify what it is about that person that you dont like. Are they

unfair or lie or show no interest or unfriendly?

CREATING A CLAY REPRESENTATION OF A VALUE ART ACTIVITY

(35 MINUTES)

This task requires the teenagers to make a clay representation of a value. The group

generally find this quite hard to get going so its important to give them some examples

of how to make a clay representation of their values. They could make something

abstract a tree if they value humans growing to their best potential, or perhaps a sun

if they value warmth and generosity, or a world if they value the environment. They will

need lots of examples from the facilitator and a discussion at the start.

Sample Dialogue:

Now I want you to think about these things that are most important to you, that

are what you want to be about, your important centre, or your favourite life. We

want you to make something in clay that will represent these things. Just like our

other tasks this can be a metaphor or an abstract sculpture. The only important

thing is that it represents what you value most in yourself and how you would

like to move toward that value.

For example, some people value relationships and being a kind person, they

might make a clay representation of hands linked together. Someone else might

value using their talent and might create a musical instrument. Some adolescents

have made plants or the world to represent growth.

Hayes & Rowse, 2008

The important thing is that this clay sculpture becomes a reminder of the

direction you value.

You can be creative in how you turn the clay into the value. The clay will set hard

without needing to be fired in a kiln.

HOME TASK

This week we would like you to nominate one thing that you can do that is in line with

what is important to you. We dont want you to choose a big thing but to notice the

small things you do too.

For example, if you value relationships you may decide to send text messages to

your friends just saying Hi,

If you value helping others, you might choose to help a special person; for

example, helping your mum with some chores (this usually elicits laughter),

Or you might choose to say hello to people you dont know really well,

Or maybe there is a part of you that is crying out I want to be me and this week

you will select one small part of this and try it out.

Ask each member what value they will be working on this week and to state this to the

group.

HANDOUTS

Provide each student with handout for this week.

Hayes & Rowse, 2008

SESSION 7: ON THE MOVE

ACT THERAPEUTIC AIM

The aim this week is to link the willingness that has been developing over the past

session into committed action and adopting a valued direction in life. In each of the past

weeks the participants have set one goal that directly related to the ACT concept for the

week. This week they will be setting goals that direct them to live life according to their

values map.

PROCESS ISSUES

This week facilitators should support the teenagers in developing a values map that is

not too overwhelming and makes clear that values are something that we continually

work towards and that we do this in small steps. In the ACT community, values are often

referred to with the analogy of travelling, if your valued direction was heading west,

you would always have more west to head towards (unless you subscribe to the theory

that the world is flat!).

Facilitators will need to help the teenagers choose goals that are in keeping with

effective behaviour change research. Goals should be small, achievable, with high

chance of success between this session and the next. Teenagers should write down their

goals and the steps they will take to move towards them.


1. Review last week

2. Road map, drawing life as a journey in a values direction using a series of

committed action

3. Draw/write goals for committed action

MATERIALS

No paint this week

A3 white paper

Oil pastels

Hayes & Rowse, 2008

Charcoal

Coloured pencils

Pencil sharpener

LOCATION

A classroom is fine this week, but the same location each week is best.

ACTIVITIES


Allow time for group participants to reflect and share on the group and its conclusion

next week. This will enable participants to start to prepare for the group ending and

preparing to take what they have experienced into their world. Each participant should

be encouraged to share some reflection on the values they worked toward during the

week. If the participants feel that they have not lived in line with values this can be

difficult and may impact on their capacity to share.

Sample Dialogue:

Welcome to week seven, the second last week of the group. How are you feeling

about what the group has been doing? How does it feel to know that next week

is our last week? What valued actions did people take during the week? How did

you go noticing when you were doing or saying something in line with the values

last week? What was it like?

ROAD MAP LIFE IS A JOURNEY WITH A SERIES OF VALUED

ACTIONS (30 MINUTES)

This task requires participants to draw a map of life and use this to plot their valued

directions and then to specify goals they could take to move in that direction. It is

important that their map does not have the value as a destination, it is instead a

direction. Some teenagers may have several directions and facilitators could encourage

Hayes & Rowse, 2008

them to have directions for different parts of their lives, for example family, friends,

self-development.

The second part of the task asks adolescents to write on their map small action changes

that they can make that commit them to heading in their valued direction. There may be

some larger goals, but the aim is for small behavioural goals with something specific

they can do before the next session and a high likelihood of success.

Sample Dialogue:

In thinking about the values we talked about last week. Today we are going to

draw a map that shows a journey toward valued living. You may remember our

first week we talked of this journey as being like a path up the mountain. Well

today we would like you to draw a road map. The road should go off the page to

show that the journey continues, we would also like you to put valued directions

on the road, with signs along the way that show what actions you could take

that will help you head in this direction.

For example, one thing I value most is being a supportive friend who cares for

others, so I might use this as my direction and along the road list some goals that

will help me keep going in that direction. A big goal toward this might be that I

could keep regular phone contact and answer email quicker. My small goal for

the week might be to contact my three closest friends, just for a chat. Of course

there probably wont be a time when I can say Ive reached my valued direction

and I will probably always need to work harder at my value of friendship.

So first have a go at drawing a road that goes off the page. Then put some

directions that should what you value. Then together we will work out some

goals that are smaller steps you could take. Remember dont pick something too

big or difficult, start small and something you could realistically do and achieve

at.

While the group are drawing their maps the facilitators should direct them to include a

few valued directions and some goals they could take. Discussion should direct

participants to set small achievable committed actions; it may require breaking a task

into smaller parts. The group discussion should also remind participants that values can

never be met; it is a direction or a journey.

Hayes & Rowse, 2008

HOME TASK

Facilitators will need to time to help each teenager come up with a plan for the week

that includes a small achievable goal. If possible ask the teenagers to write their goals

for the week on a small card. Some teenagers will not be willing to do this, however,

they might be encouraged to take a photo of their map with their cell phones and use

this as a reminder of the commitment they have made. They could even put a reminder

in their cell phones!

HANDOUTS

Provide each student with handout for this week.

Hayes & Rowse, 2008

SESSION 8: REFLECT AND REMEMBER

ACT THERAPEUTIC AIM

In this final week, the aim is to have participants reflect on the group and what they

have learned. We will review each of the ACT concepts and discuss the overall aim of

the group, which is learning that you can live your life in a valued direction, whilst

accepting difficult experiences and being willing to take this with you.

PROCESS ISSUES

Facilitators

Celebrate with food


1. Review home task

2. Reflection on artwork and what has been Group discussion

3. Create a poem or piece of writing that reflects their experience Art activity

4. Celebration and collection of outcome measures

Final thoughts from Kirsty (14 years)....:

A gracious smile with so much warmth,

A kind face to look upon,

A mile of nice to share with us,

With minds so caring, feelings so wide,

Draw we shall, to share with all

....weeks of bliss

Hayes & Rowse, 2008

MATERIALS

Celebration food if desired

Outcomes or evaluation measures

Special paper for poetry and scrap paper for drafts

Oil pastels

Charcoal

Coloured pencils

Pencil sharpener

Paper towel

LOCATION

Classroom is fine this week.

ACTIVITIES


We begin this final week, as always, with a review of the home task and a discussion of

how the participants went during the week. For this week, the discussion will be focused

on what each participants goals for valued living were, and what action they were able

to take during the week. For some participants this may include providing support for

obstacles that prevented them from taking action.

Allow time for each person to share what their plan was and how they went with it.

NOTE: participants can now take their work home with them. Facilitators may like to

provide some materials so the artwork can be combined into a folio. However, some

adolescents will choose not to do this because they worry about privacy at home.

Hayes & Rowse, 2008

REFLECTION ON ARTWORK AND WHAT HAS BEEN LEARNED

GROUP DISCUSSION (15 MIN)

In this session each students artwork should be spread out in front of them (or themed

by week for the whole group). The facilitators can then review each weeks main topic

and guide a discussion on what the group learned from each session. The students

should also be asked to reflect on their own and others paintings.

In the reflective discussion about the groups experience, ensure key principles of

acceptance, willingness, being present, self as context, values and committed action are

covered in some way in the discussion.

CREATE A POEM OR PIECE OF WRITING THAT REFLECTS THEIR

EXPERIENCE ART ACTIVITY

This final activity asks the teenagers to write a piece of poetry or a reflection on their

experience of the group and what the will take with them. For some teenagers this is

quite a stretch, however, facilitators can encourage them and reinforce their willingness

to participate in the task.

Facilitators may also need to model their own willingness and be creative. We have

found this works best if facilitators model a poem that extends themselves too, but is

not quite perfect!

Some suggestions for writing style include:

Writing a poem

Writing a reflection

Writing an acrostic poem

Writing a narrative or story

Sample Dialogue:

Hayes & Rowse, 2008

Today we are going to write a poem or catch phrase about our experience of

being in the group, what we have learnt, and what we would like to remember

from the experience. We will then write it on good paper and decorate it as a

reminder of the group.

CLOSING CELEBRATION

Create a formal way to celebrate saying goodbye to each group member. This could also

include some celebratory discussions with each group member on their involvement

with the group, their successes and achievements.

HANDOUTS

No handouts this week


HANDOUT 1: WHERE AM I ?

Weve all heard how the journey is more important than

the destination, right? During this week your task is to

notice where you are on your journey.

Notice the times when you feel that things are not going too

well, or in other works when you are lost in the bush. Its OK

to have these times.

Also notice the times when things are going along OK or

really well; the times when you can see the top of the

mountain.

Our journeys are unpredictable. Be willing to share

some of what you noticed next week.

I noticed that.......................................................................

..................................................................................................


HANDOUT 2: THOUGHTS: TRAPPED OR FLEXIBLE?

We all have difficult thoughts and feelings. This week we would like you to

participate in an experiment that we will share next week:

When you have a difficult thought do one of these things:

(1) notice when you are trying to win over the thought

and what happens when you do this, just notice it, you

dont need to change or do anything different;

and.....

(2) notice times when you are able to let a difficult thought just

be there in other words when you dont struggle with it.

Remember this is just an experiment!. Try both ways and see

what you can report back to the group next week.

When I struggle with difficult thoughts I

discovered....................................................................................

When I let difficult thoughts float on by, I

discovered....................................................................................

.


HANDOUT 3: DEVELOPING WILLINGNESS

This week practice being willing. This means being willing to have your

thoughts, and making room for difficulties.

1. Choose one thing in your life that difficult thoughts get in the way of,

2. Notice when you are pulling hard on the rope and trying to drag your

difficult thoughts into a place where you can forget them,

3. Practice being willing to let difficult thoughts be there (dropping the

rope).

What will you be willing to work on this week?

................................................................................................................................................

change what you can change,

accept what you cant change,

& practice noticing the

difference


The blah, blah, blah RAP

Thats bad.

Youre bad.

Its a catastrophe!

No one will like you if you

do that.

Be careful.

Stop it!

HANDOUT 4: INSIDE MY MIND

This week we learnt that our mind generates thoughts and we talked of ways

to experience our thoughts differently. Here are some ideas to try:

Bad News Radio

Our mind generates thoughts like

a Bad News Radio broadcasting

24-hours a day.

Sometimes it gets carried away

with reminding us of bad things

from the past, warning us of bad

things to come, and giving regular updates on everything

wrong with us. Every now and then it broadcasts something useful or nice.

So, if were always listening and believing everything we hear then well end

up miserable. Unfortunately theres no way to switch off this radio. In

fact, the more we try the louder it plays.

There is an alternative. Have you ever heard a radio playing in the

background and were so intent on what you were doing you didnt really hear

it? You could hear it playing, but werent paying attention.

Let your Bad News Radio play on

and get on wit

Documents

ACT.experiential.group .for .Adolescents.L.hayes .2008